Navigating Insurance Company Tactics After an Accident

After a serious accident, most injury victims expect the insurance company to cover their losses fairly. Unfortunately, that’s not always how it works. Insurance companies are for-profit businesses, and their goal is to pay out as little as possible. While they may appear friendly and concerned, their adjusters and claims representatives are trained to use strategies that reduce or deny claims.

Knowing these tactics can help you protect your rights and increase your chances of receiving the compensation you deserve.

Understanding the Insurance Company’s Goals

Insurance companies earn profits by collecting premiums and investing them, not by paying out large claims. The less they pay for your accident, the more money they keep. According to the Insurance Information Institute, U.S. property and casualty insurers saw a combined net income of over $44 billion in 2023. That figure reflects how tightly they control payouts.

Their approach often includes:

• Quickly offering low settlements before you know the full extent of your injuries.
• Delaying claims to pressure you into accepting less.
• Using your statements against you to deny liability or reduce your claim’s value.

Common Tactics Used to Minimize Payouts

1. Early Lowball Settlement Offers

One of the most common strategies is making a quick settlement offer shortly after your accident. This often happens before you have completed medical treatment. The insurance company hopes you’ll accept the offer and sign away your right to seek additional compensation later. Once you accept, you cannot reopen the claim — even if your medical bills are higher than expected.

How to Protect Yourself: Never accept a settlement without fully understanding your injuries, future medical needs, and other damages. Consult with an attorney before signing any release forms.

2. Delaying the Claims Process

Insurance companies may drag out the process, knowing that medical bills and lost wages can put financial pressure on accident victims. Delays can include slow responses to calls, requests for repeated paperwork, or claiming that documents were never received.

How to Protect Yourself: Keep detailed records of all communications. Respond promptly to requests for information, and follow up regularly to keep your claim moving.

3. Requesting Excessive Documentation

While insurers need certain records to process a claim, some requests go far beyond what’s necessary. They may ask for years of medical history unrelated to your injury to find a pre-existing condition they can use to deny your claim.

How to Protect Yourself: Provide only the documents relevant to your injury and accident. If you’re unsure, have your lawyer review requests before sending records.

4. Disputing Liability

If there’s any uncertainty about how the accident happened, insurers may claim you were partially or fully at fault. In Pennsylvania, the modified comparative negligence rule means you can only recover damages if you are 50% or less at fault. Your compensation is reduced by your percentage of fault.

For example, if you were found 20% at fault for an accident with $100,000 in damages, you could only recover $80,000.

How to Protect Yourself: Gather strong evidence such as police reports, witness statements, and photos. An attorney can help challenge unfair fault determinations.

5. Using Recorded Statements Against You

An adjuster might ask you to give a recorded statement “to get your side of the story.” While it may sound harmless, these statements are often used to catch you making inconsistent or vague comments that can later be interpreted as admitting fault.

How to Protect Yourself: Politely decline to give a recorded statement without legal advice. You are not required to provide one to the other driver’s insurer.

6. Downplaying Medical Injuries

Insurance companies may argue that your injuries are not as severe as claimed, or that they were caused by something other than the accident. They might hire their own medical experts to dispute your doctor’s diagnosis.

How to Protect Yourself: Follow your doctor’s treatment plan, attend all appointments, and keep a personal injury journal documenting pain levels, symptoms, and limitations.

7. Using Surveillance

Some insurers hire investigators to follow claimants and capture photos or videos. If they record you doing activities that seem inconsistent with your reported injuries, they may use that to deny your claim — even if the footage doesn’t tell the full story.

How to Protect Yourself: Be mindful of your activities and social media posts while your claim is pending.

8. Pressuring You to Use Their Network Providers

Insurers may encourage you to see certain doctors or repair shops. While this isn’t always harmful, these providers may have relationships with the insurer and could produce reports that favor their position.

How to Protect Yourself: You have the right to choose your own medical providers and repair services.

9. Offering Lump Sum Settlements for Ongoing Care

Some accident victims require ongoing treatment or therapy. Insurers may offer a lump sum that seems generous but doesn’t account for long-term costs like future surgeries or loss of earning capacity.

How to Protect Yourself: Have a professional evaluate the full value of your claim, including projected future expenses.

10. Misrepresenting Policy Terms

Occasionally, adjusters may interpret policy language in a way that limits your benefits — even if that interpretation is questionable.

How to Protect Yourself: Ask for all policy explanations in writing. Review your policy carefully and, if necessary, have a lawyer analyze it.

The Role of Pennsylvania Law

Pennsylvania has its own laws that affect personal injury claims. Knowing these can help you understand the insurer’s tactics:

• Statute of Limitations: You generally have two years from the date of injury to file a personal injury lawsuit.
• Comparative Negligence Rule: As noted, you can only recover if you are 50% or less at fault.
• Bad Faith Claims: Under Pennsylvania’s bad faith law, you can sue an insurer for acting in bad faith, which could result in extra damages, including attorney fees and interest.

Real-World Data: Why Insurance Companies Fight Hard

• The average bodily injury claim payout in the U.S. was around $24,000 in 2022, according to the Insurance Research Council.
• Even with insurance, medical debt is a major issue — a 2022 Kaiser Family Foundation survey found that about 41% of U.S. adults have some form of medical debt.
• For auto claims, Pennsylvania drivers face an average bodily injury liability premium of $518 per year — meaning insurers have every reason to keep payouts low to maintain profits.

How to Protect Yourself After an Accident

1. Seek Medical Care Immediately – This documents your injuries and creates evidence for your claim.
2. Keep Detailed Records – Save bills, receipts, and communication logs.
3. Avoid Social Media Posts – Anything you post could be used against you.
4. Do Not Accept Early Offers – These are often far below what you may be entitled to.
5. Consider Legal Representation – A lawyer can negotiate with insurers and protect your rights.

Why Professional Help Matters

Insurance companies have teams of lawyers, adjusters, and investigators working to protect their interests. Without experienced representation, you may find it difficult to counter their tactics — especially if you’re also trying to recover from an injury.

For more than 40 years, Metzger & Kleiner, Attorneys at Law has helped injury victims in Philadelphia and the Lehigh Valley stand up to insurance companies. We understand their strategies and know how to fight for fair compensation. Our attorneys are accessible, client-focused, and work on a contingency fee basis — you don’t pay unless we win your case.

If you’ve been injured in an accident and are dealing with an insurance company, contact Metzger & Kleiner at 215-567-6616 (Philadelphia) or 610-435-7400 (Lehigh Valley) for a free consultation.